Mar 1, 2019 Issue
Gas, Bloating, and Belching: Approach to Evaluation and Management [Article]

Gas, bloating, and belching are primarily caused by functional gastrointestinal disorders; psychological distress can make symptoms worse. Exhaustive testing is not necessary for diagnosis. Most patients are classified as having gastric or small bowel bloating, bloating with constipation, or belching disorders. Patients with symptoms of irritable bowel syndrome should be tested for celiac disease; patients with chronic constipation should have a rectal examination. There is insufficient evidence to support the routine use of highly restrictive exclusion diets except in patients with confirmed celiac disease.

Jun 15, 2018 Issue
Drugs for Chronic Idiopathic Constipation Are Similarly Effective [POEMs]

If nondrug measures are unsuccessful for chronic idiopathic constipation, the choice of a pharmacologic agent should be based on cost, tolerability, and long-term adherence rather than efficacy, because the efficacy is similar among drugs and drug classes.

Oct 1, 2017 Issue
Laxatives for the Management of Childhood Constipation [Cochrane for Clinicians]

Polyethylene glycol (PEG) is superior to placebo (mean difference [MD] = 2.61 more stools per week; 95% confidence interval [CI], 1.15 to 4.08), lactulose (MD = 0.70; 95% CI, 0.10 to 1.31), and milk of magnesia (MD = 0.69; 95% CI, 0.48 to 0.89) at increasing the number of bowel movements per week at two to 12 weeks.

Sep 15, 2015 Issue
Management of Constipation in Older Adults [Article]

Find out which bulking agents, osmotic and stimulant laxatives, and stool softeners are most effective. Also, review key behavioral interventions that can help prevent constipation in this population.

Jul 15, 2014 Issue
Evaluation and Treatment of Constipation in Children and Adolescents [Article]

Learn the differential diagnosis of constipation in children and effective treatments, such as parental education, behavior interventions, diet changes, and medications.

May 1, 2014 Issue
20-Year History of Diarrhea with Intermittent Constipation [Photo Quiz]

Photo Quiz presents readers with a clinical challenge based on a photograph or other image.

Dec 1, 2011 Issue
Management of Constipation in Patients Receiving Palliative Care [Cochrane for Clinicians]

There is insufficient evidence to recommend one laxative over another for the treatment of constipation in patients receiving palliative care. Methylnaltrexone can increase the frequency of bowel movements at four hours (odds ratio = 7.0; 95% confidence interval, 3.8 to 12.6) and at 24 hours (odds r...

Aug 1, 2011 Issue
Diagnostic Approach to Chronic Constipation in Adults [Article]

Constipation is traditionally defined as three or fewer bowel movements per week. Risk factors for constipation include female sex, older age, inactivity, low caloric intake, low-fiber diet, low income, low educational level, and taking a large number of medications. Chronic constipation is classifi...

Apr 15, 2011 Issue
Constipation in Adults [Clinical Evidence Handbook]

What are the effects of nondrug interventions, fiber supplements, and paraffin in adults with idiopathic chronic constipation? What are the effects of stimulant and osmotic laxatives? What are the effects of prostaglandin derivatives and 5-hydroxytryptamine 4 receptor agonists in persons with idiopathic chronic constipation?

Sep 15, 2010 Issue
Methylnaltrexone (Relistor) for Opioid-Induced Constipation [STEPS]

Methylnaltrexone can temporarily relieve opioid-induced constipation in patients with advanced illness who have not responded to laxative treatment. However, it must be given by injection, is expensive, and has been studied only for short-term use.

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